A private company hired to support NHS services potentially put patient safety at risk by failing to check whether doctors are suitably qualified among other failings, according to a new report.

Capita, which has been contracted to provide various support services across England, wrongly told dozens of women they were no longer a part of the cervical screening programme, the National Audit Office (NAO) report found.

Service failures led to 87 women being incorrectly notified that they were no longer part of the cervical screening programme the report found, adding that “no actual harm has been identified”.

It also said that patients could potentially have been put at risk due to problems with the “performers list” – a list of GPs, dentists and opticians practising in the NHS, including whether they are suitably qualified and have passed other relevant checks.

“The failure to update performers lists may have compromised patient safety in cases where practitioners should have been removed,” the authors said.

Problems with the list also led to hundreds of health workers being unable to work. In 2016, delays in processing new applications for the lists resulted in around 1,000 GPs, dentists and opticians being unable to work.

As well as keeping these health workers away from the frontline, it also meant that NHS England has been forced to pay out for “lost earnings” due to the delays.

£330m contract

As part of its seven-year £330m contract, Capita also organises GP and pharmacy payments and GP pensions, the moving of medical records – for example if someone changes GP practice – payments to opticians and providing NHS stationery, pre-printed forms, and needles and syringes for primary care.

The contract was agreed in 2015 with the aim of reducing primary care support service costs by 35 per cent, with a view to modernising the service. But the service has suffered a number of set backs including doctors reporting problems with the transfer of medical documents, and problems caused by shortages of stock in the NHS supply chain.

The NAO report concludes that NHS England has largely secured the financial savings it expected – in the first two years of the contract, NHS England made savings of £60m.

But the authors of the report wrote: “NHS England has not yet secured the transformation that it wanted. The service to primary care practitioners, including Capita’s delivery of PCSE, has fallen a long way below an acceptable standard.

“This had an impact on the delivery of primary care services and had the potential to seriously harm patients, although no actual harm to patients has been identified.”

The authors acknowledge that Capita’s self-reported performance against the contract has improved. But they questioned whether some of the services should be taken “in-house” by NHS England.

Amyas Morse, the head of the NAO, said “Neither NHS England nor Capita fully understood the complexity and variation of the services being outsourced. As a result, both parties misjudged the scale and nature of the risk in outsourcing these services.

“While NHS England has achieved financial savings and some services have now improved, value for money is about more than just cost reduction.”

‘Mismanagement’

Commenting on the report, Henrik Overgaard-Nielsen, the British Dental Association’s chairman of General Dental Practice, said: “NHS England needs to take ownership over the grotesque mismanagement at Capita. Hundreds of NHS dentists have been unable to provide care for patients, or support their families, because officials were fixated on quick savings.”

Meg Hillier, chairwoman of the Public Accounts Committee, said: “Trying to slash costs by more than a third at the same time as implementing a raft of modernisation measures was over-ambitious, disruptive for thousands of doctors, dentists, opticians and pharmacists and potentially put patients at risk of serious harm.”

An NHS England spokesman said: “While not without its difficulties, by making this change over the past two years the NHS has successfully saved taxpayers £60 million, as the NAO themselves confirm.

“This £60 million in lower administrative cost has all been successfully reinvested in frontline NHS patient care, and has helped fund the equivalent of an extra 30,000 operations.”

A Capita spokeswoman added: “The report notes that several organisations and legacy issues all contributed to underperformance. It has been acknowledged that performance has improved and Capita will continue to work with all parties to address the small number of remaining service issues.

“We have accepted accountability for not meeting our high standards of service previously.”

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